Provider Demographics
NPI:1588210579
Name:HOLISTIC CARE SERVICE LLC
Entity Type:Organization
Organization Name:HOLISTIC CARE SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDMUND
Authorized Official - Middle Name:E
Authorized Official - Last Name:ABAKPORO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-577-9765
Mailing Address - Street 1:4150 IDLE HOUR CIR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45415-3316
Mailing Address - Country:US
Mailing Address - Phone:717-577-9765
Mailing Address - Fax:
Practice Address - Street 1:4150 IDLE HOUR CIR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45415-3316
Practice Address - Country:US
Practice Address - Phone:717-577-9765
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-14
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle